The Case Western Reserve University AIDS Clinical Trials Unit serves a 5.4 million population region that accounts for 47% of Ohio's AIDS cases. This section provides rationale for the continuation of an established ACTU that is a vital community resource and is an important contributor to the national ACTG effort. This Cleveland and Toledo-based ACTU has a strong record of cost efficient accrual of patients including underserved minorities into ACTG trials. To provide additional trials access to minority populations, a second ACTU subunit will be established at MetroHealth Medical Center, a county hospital on Cleveland's West Side that serves large African-American and Hispanic communities. The main ACTU and its two subunits are the three largest HIV care providers in Northern Ohio and each provides care without regard to ability to pay. As both HIV care providers and AIDS researchers, these units integrate clinical care and clinical research and their staff have earned the trust and confidence of their patients and communities. Outreach to populations currently under-represented in ACTG trials is a major component of ACTU activities. These Units project a minimum accrual of 140 patients per year to ACTG trials.